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一项真实世界研究,首次在英国国家医疗服务体系中使用哌柏西利治疗晚期乳腺癌,该研究是新型药物爱博新®患者项目的一部分。

A real-world study of the first use of palbociclib for the treatment of advanced breast cancer within the UK National Health Service as part of the novel Ibrance® Patient Program.

机构信息

The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK.

Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK.

出版信息

Br J Cancer. 2023 Sep;129(5):852-860. doi: 10.1038/s41416-023-02352-5. Epub 2023 Jul 19.

Abstract

BACKGROUND

The Ibrance® Patient Program was established to provide access to palbociclib for UK National Health Service (NHS) patients with metastatic breast cancer (MBC), pending a funding decision.

METHODS

Non-interventional cohort study involving a retrospective medical record review of patients commenced on palbociclib between April and December 2017 at eight UK centres. Primary outcomes included clinicopathological characteristics, treatment patterns, clinical outcomes and selected adverse events.

RESULTS

Overall, 191 patients were identified, median age of 57.0 years (range 24.3-90.9); 30% were diagnosed with de novo MBC; 72% received first-line and 10% as ≥ second-line treatment. Median progression-free survival (95% CI) was 22.8 months (16.5-not reached [NR]) in first-line; NR in patients with de novo MBC; 7.8 months (6.8-NR) in ≥ second-line (median follow-up: 24 months). Median overall survival (OS) was NR in the overall cohort; OS rate (95% CI) at 24 months was 74.2% (67.1-81.9%) in first-line; 82.1% (72.6-92.8%) in patients with de novo MBC; 55.0% (37.0-81.8%) in ≥ second-line. Forty-seven per cent of patients developed grade 3-4 neutropenia; 3% febrile neutropenia.

CONCLUSION

This study supports the effectiveness of palbociclib and demonstrates the benefit to patients of early access schemes that bridge the gap between regulatory approval and NHS funding for new medicines.

CLINICAL TRIAL REGISTRATION

Clinical trial: ClinicalTrial.gov:NCT03921866.

摘要

背景

Ibrance® 患者计划旨在为英国国家医疗服务体系(NHS)中患有转移性乳腺癌(MBC)的患者提供帕博西尼治疗,等待资金决定。

方法

这是一项非干预性队列研究,涉及对 2017 年 4 月至 12 月在英国八家中心开始使用帕博西尼的患者进行回顾性病历审查。主要结局包括临床病理特征、治疗模式、临床结局和选定的不良事件。

结果

总共确定了 191 名患者,中位年龄为 57.0 岁(范围 24.3-90.9);30%的患者诊断为初发性 MBC;72%的患者接受一线治疗,10%的患者接受二线及以上治疗。在一线治疗中,中位无进展生存期(95%CI)为 22.8 个月(16.5-NR);初发性 MBC 患者为 NR;二线及以上治疗为 7.8 个月(6.8-NR)(中位随访:24 个月)。总体队列的中位总生存期(OS)为 NR;OS 率(95%CI)在 24 个月时为一线治疗组的 74.2%(67.1-81.9%);初发性 MBC 患者为 82.1%(72.6-92.8%);二线及以上治疗组为 55.0%(37.0-81.8%)。47%的患者发生 3-4 级中性粒细胞减少症;3%发生发热性中性粒细胞减少症。

结论

这项研究支持帕博西尼的有效性,并证明了早期获取计划对患者的益处,这些计划缩小了新药监管批准和英国国家医疗服务体系资金之间的差距。

临床试验注册

临床试验:ClinicalTrials.gov:NCT03921866。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/440a/10449843/417eb989d531/41416_2023_2352_Fig1_HTML.jpg

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